Philosophiae Doctor - PhD / Type 2 Diabetes Mellitus (T2DM) constitutes the highest percentage of diabetes cases. It has become a serious global problem due to rapid cultural and social changes, ageing, increasing urbanisation, dietary changes, reduced physical activity and unhealthy behavioural lifestyles. Furthermore, unidentified diabetes has been found to be common in many parts of Africa, including rural Nigeria, due to factors such as poor accessibility to health facilities, cultural barriers and high rates of health illiteracy. The overall aim of this study is to determine the effectiveness of the Diabetes Self Management Education (DSME) programme among individuals with T2DM in Jigawa State, Nigeria.

Inom Sjukvårdens akutmottagningar ökar antalet vårdsökande patienter. Det växande vårdbehovet medför ökade resurskrav i form av personal, kompetens, vårdplatser och utrustning. Efterfrågan på sjuksköterskor är stor och behovet förväntas öka de kommande åren. Tillgången på sjuksköterskor har betydelse för patientsäkerheten i vården och det råder en obalans mellan efterfrågat vårdbehov och resurser. Samtidigt noteras stigande sjuktal bland sjuksköterskor inom hälso- och sjukvården vilket är oroväckande då personalbortfall påverkar vårdproduktionen. Syftet var att belysa faktorer som kan påverka arbetsrelaterad ohälsa hos sjuksköterskor på akutmottagning. Arbetet genomfördes med hjälp av litteraturöversikt och data bearbetades med hjälp av integrativ analys. I litteraturöversikten inkluderades 18 artiklar efter artikelsökning i databaserna PubMed, CINAHL Complete samt EBSCOhost. Sökorden emergency department, emergency nurse, nurse, work related, work och occupational health användes. Inkluderade artiklar analyserades enligt integrativ analys. Domäner som framträdde var stress, hot och våld samt organisation. Vid analys av resultaten identifierades sju underliggande faktorer som påverkade arbetsrelaterad ohälsa. Resultatet i denna litteraturöversikt belyser de sju identifierade faktorerna som påverkade arbetsrelaterad ohälsa hos sjuksköterskor på akutmottagning. Dessa faktorer var vårdtyngd, arbetsledning, anställningsförhållanden, sjuksköterskors utbildningsnivå och yrkeserfarenhet, hot och våld, personen bakom hot och våld samt situationen bakom hot och våld. Dessa faktorer tycks vara integrerade med varandra i bemärkelsen att de kan påverka varandra. Slutsatsen var bland annat att när personalresurserna upplevdes för låga eller när vårdtyngden upplevdes för hög uppstod stress. Arbetstider, bristande belöningssystem, otydlig arbetsledning och återkoppling kunde bidra till arbetsrelaterad ohälsa. Sjuksköterskorna efterfrågade tydligt definierade roller, att få arbeta autonomt och att ha tillgång till kompetensutveckling. Då detta saknades kunde missnöje och ohälsa uppstå. Seniora sjuksköterskor och sjuksköterskor med högre utbildningsnivå fick mer ansvar och hade högre förväntningar på sig vilket kunde bidra till ohälsa om inte deras ansvar och arbetsuppgifter definierades. Hot och våld mot sjuksköterskor förekom på akutmottagningar. Personer samt situationer kunde i sig vara faktorer som ledde till hot och våld där våldet var en direkt arbetsrelaterad skada/ohälsa. Flera av de faktorer som kan bidra till arbetsrelaterad ohälsa står i strid till vad som åligger sjuksköterskor i deras etiska kod vilket skulle kunna orsaka moraliska konflikter.

Due to societal and economic costs caused by compulsive consumption behavior, specifically problem drinking and overeating, a search has been launched for a cognitive explanation for the ‘deviant’ behaviors and the motivations that cause these behaviors to continue. This dissertation attempted to develop a better understanding of continued compulsive consumption behavior by investigating consumers’ use of the techniques of neutralization theory. Based on methodological concerns in neutralization research, the development of reliable and valid measures of the five techniques of neutralization theory were described and used to examine their moderation of compulsive consumption behavior and its relationship with social norm commitment and guilt. The dissertation resulted in developing four reliable and valid neutralization technique scales. The results of the structural model suggested a negative relationship between social norms and compulsive consumption behavior and a multiple regression indicated a partial moderation of certain neutralization techniques of this relationship. This dissertation has provided a better understanding of the cognitive process surrounding a consumer’s compulsive consumption behavior, the techniques used to allow the behavior to continue, and marketing applications to entice consumers to stop the behavior.

No description available.

Tyrimo objektas - 16-19 m. Kauno ir Šiaulių gimnazijų moksleivių fizinio aktyvumo, žalingų įpročių ir subjektyvaus sveikatos vertinimo sąsajos. Tyrimo tikslas: įvertinti Kauno ir Šiaulių gimnazijų 16-19 m. moksleivių fizinio aktyvumo, žalingų įpročių ir subjektyvaus sveikatos vertinimo sąsajas. Uždaviniai: 1. Nustatyti moksleivių fizinį aktyvumą lyties, amžiaus ir gyvenamosios vietos aspektu. 2. Nustatyti moksleivių žalingų įpročių paplitimą lyties, amžiaus ir gyvenamosios vietos aspektu. 3. Atskleisti moksleivių fizinio aktyvumo, žalingų sveikatai įpročių ir subjektyvios sveikatos vertinimo tarpusavio ryšį. Hipotezė: fiziškai pasyvesni moksleiviai labiau linkę į žalingus įpročius ir skundžiasi prastesne sveikata. Tyrimo imtis ir organizavimas. Anketinė apklausa buvo vykdoma 2013 m. lapkričio 2014 m. sausio mėnesiais Kaune ir Šiauliuose, kiekvienam tiriamajam taikant anketavimo metodą. Iš viso apklausta 316 moksleivių. Iš jų 161 Kauno mieste ir 155 Šiauliuose. Išvados: 1. Pakankamai fiziškai aktyvūs buvo tik 28,9 proc. visų apklaustų moksleivių. Buvo nustatyta, kad vaikinų dalis, kurie laisvalaikio metu mankštindavosi kasdien arba beveik kasdien buvo dvigubai didesnė dalis negu merginų. 18-19 m. amžiaus moksleiviai rečiau buvo fiziškai aktyvūs kasdien ar beveik kasdien negu 16-17 m. amžiaus mokiniai. Nustatyta, kad Šiaulių mieste kiekvieną dieną fizine veikla užsiiminėjo 33,8 proc., tuo tarpu Kauno mieste kasdien ar beveik kasdien aktyvių moksleivių buvo tik 24,2 proc. 2... [toliau žr. visą tekstą] / Subject – the relationships between physical activity, unhealthy lifestyle-related habits and self-rated health of 16-19 year old students of gymnasium schools of Kaunas and Šiauliai cities. Aim of the study: to assess the relationship between physical activity, unhealthy lifestyle-related habits and self-rated health of 16-19 year old students of gymnasium schools of Kaunas and Šiauliai cities. Objectives: 1. To evaluate physical activity of the students according to age, gender and place of residence. 2. To assess the prevalence of unhealthy lifestyle-related habits of the students in respect of the aspect of age, gender and place of residence. 3. To reveal the relationships between physical activity, unhealthy lifestyle-related habits and self-rated health. Hypothesis: those students who are physically passive tend to have more of unhealthy lifestyle-related habits and worse perceived health. Sample and organization. A questionnaire survey was conducted in the period of November, 2013, – January, 2014 in Kaunas and Šiauliai with the questionnaire survey method applied to each of the responder. In total 316 students were surveyed, of which 161 – In Kaunas and 155 – in Šiauliai city. Conclusions: 1. Only 28.9 % of all the responders met the WHO physical activity criteria. The part of boys who during their leisure time did exercises on a daily or almost daily basis was twice bigger than the one of girls. 18-19 year old students appeared to be less frequently physically active... [to full text]

Our physical, social and mental health are all important for our wellbeing and no one should feel ill or mistreated because of their work situation. Despite this, an increasing number of people are suffering from unhealthy workload or victimization at work. Mental illness is an increasing problem and cost society around 70 billion SEK each year, 50 % of which can be related to loss in production caused by sick-leave. In addition to the immeasurable human costs, Sweden now faces one of its greatest challenges in modern time. In order to counteract this development, the Swedish Work Environmental Authority released new provisions regarding the organisational and social work environment called AFS 2015:4 which are aimed at all activities where an employee perform work on the employers account. The purpose of this thesis is to contribute to the understanding of difficulties and possibilities when revising current work practices to fulfil the provisions. The thesis uses a case study approach taking place in an organisation within Svevia, a Swedish construction company, using a literature review, a document analysis, interviews and a questionnaire. The findings indicate that even though the organisation had major efforts put into their work environment management, there were improvements to be made regarding the organisational and social work environment. Furthermore, what can be improved and how the organisation can support the improvements to fulfill the provisions and work towards a better work environment is concluded. The results are of great practical use not only to the case organisation but to all organisations similar in nature.

Dagens skärmbundna generation lider av fetma och övervikt. Fler människor dör av fetma än av svält. Trots detta är träning och hälsa något som det läggs väldigt mycket fokus på i dagens samhälle. En vacker och vältränad kropp är ett sätt att uppnå prestige och status. Syftet med detta arbete är att undersöka personliga tränares syn på motionärers olika förhållningssätt till träning på gym. Genom att intervjua personliga tränare med hjälp av kvalitativa intervjuer har detta fenomen undersökts. Resultatet visar att det är problematiskt och att överdriven träning existerar. Det råder i allmänhet en stor okunskap om hur man ska träna. Detta leder till ohälosamma förhållningssätt till träning som exempelvis överträningssyndrom och ortorexi. Huvudorsaken till ett ohälsosamt förhållningssätt till träning var enligt resultatet en brist av distans till träning samt okunskap. Skiftet från hälsosam till ohälsosam träning sker när det inte längre är kul utan är ett tvång och ett måste att träna. Träningen är något som blir en identitet och det centrala i livet. Träningen blir allt. / The screen bound generation in today’s society is suffering from obesity. More people are dying from obesity than starvation, despite this fact training and health is a massive focus in today’s society. A beautiful and fit body is a way to acquire prestige and status. The purpose of this study is to examine how personal trainers view of trainer´s different approaches to training in gym´s. This phenomenon has been researched by doing qualitative interviews with personal trainers. The results indicate that there is a problem and excessive training exists. The common man has little to no knowledge on how they are supposed to train. This leads to unhealthy approaches to training like for example overtraining syndrome and orthorexia. The main reason to unhealthy approaches to training was a lack of distance to training and a lack of knowledge. The shift from healthy to unhealthy is when it isn’t fun anymore, it is a must and something you haft to do. Training is something that becomes an identity and the central part of life. Training becomes everything.

Die Etablierung eines gesunden Ernährungsverhaltens unserer Kinder ist die wichtigste Voraussetzung für ihre körperliche, kognitive und emotionale Entwicklung. Dabei sind neben einer genetischen Disposition und kulturellen Gegebenheiten vor allem die Einflüsse der jeweiligen Betreuungspersonen ausschlaggebend. Die Eltern steuern sowohl direkt (durch Aufforderungen, Verbote u.ä.) als auch indirekt (durch die Förderung eigenverantwortlicher Entscheidungen u.ä.) das Ernährungsverhalten ihres Kindes. Untersuchungen zum mütterlichen Steuerungsverhalten konzentrierten sich bisher vorwiegend auf die Betrachtung direkter Strategien sowie auf altershomogene und sozial besser gestellte Gruppen. Aufgrund möglicher Verzerrungen durch die Betrachtung einzelner Ausschnitte des Zusammenhangs zwischen Steuerung und Ernährung wurde in der vorliegenden Arbeit ein Gesamtmodell spezifiziert, welches den Zusammenhang zwischen elterlicher Steuerung und kindlicher Ernährung unter Berücksichtigung von Sozial- und Gewichtsfaktoren abbildet. Dazu wurden drei Erhebungen mit insgesamt über 900 Müttern 1 – 10-jähriger Kinder durchgeführt. Innerhalb dieser Untersuchungen ist es gelungen, erstmalig ein deutschsprachiges Instrument zur Messung elterlicher Steuerungsstrategien in der Essenssituation (ISS) zu entwickeln. Die Analysen zeigten, dass bisher nur selten untersuchte Strategien, wie das explizite Bemühen um Vorbildwirkung und das Erlauben von eigenverantwortlichen Entscheidungen des Kindes, von den Müttern häufig angewandt werden. Die Analyse des komplexen Wirkungsgefüge von Steuerung, kindlicher Ernährung sowie sozialer und gewichtsbezogener Faktoren zeigte weiterhin, dass neben stabilen Faktoren, wie dem mütterlichen Status und dem Alter des Kindes, ein entscheidender Anteil der mütterlichen Steuerungsstrategien für die kindliche Ernährung verantwortlich ist. Die berichteten Ergebnisse zeigen auf, wie relevant die gemeinsame Betrachtung von gesunden und problematischen Nahrungsmitteln sowie die den Zusammenhang zwischen Steuerung und Ernährung beeinflussenden Faktoren innerhalb eines Modells ist. Zusammengefasst scheint vor allem die Steuerung durch Belohnung von und mit bestimmten Nahrungsmitteln eine für das kindliche Ernährungsverhalten und das Übergewichtsrisiko besonders kritische Strategie zu sein. Dies ist umso bedeutender, als bisherige Untersuchungen dieses Verhalten häufig in restriktive Strategien integriert betrachteten. Die separate Analyse wies jedoch darauf hin, dass vor allem die belohnenden Verhaltensanteile relevant sind. Dies zeigt, dass es für die Entwicklung einer gesunden kindlichen Ernährung tatsächlich veränderbare Verhaltensweisen gibt, die Eltern in Präventionsprogrammen oder anderen mit Kursen zum kindlichen Wohl assoziierten Einrichtungen vermittelt werden können. / The establishment of healthy eating for our children is an important precondition for their physical, cognitive, and emotional development. Besides genetic and cultural effects that influence children’s food preferences and eating behavior, parents play a pivotal role. Both direct (e.g., demands and restrictions) and indirect strategies (e.g., modeling and monitoring) are used to influence the child’s eating. Previous research about maternal feeding strategies has concentrated mostly on either direct feeding strategies or age-homogenous samples with high social status. To avoid bias by ignoring interdependencies I have explored the association of maternal feeding strategies and the child’s food intake in a complex model, which includes socio-demographic and weight aspects. I undertook three investigations with a total of over 900 mothers of 1- to 10-year-old children. I achieved to develop a German instrument for measuring the parental feeding strategies (ISS). Further analyses showed that rarely examined strategies, such as an explicit modeling or allowing the child to control his food, were often used. We examined a multi-factorial model of the relationship between maternal feeding practices and child’s food intake, taking into account the influences of age, socioeconomic and weight factors. This underlines the relevance of some feeding strategies (namely rewarding and modeling) besides the influence of the child’s age and the mother’s social status. The described results demonstrate the need for considering a model including healthy and unhealthy foods as well as demographic, age and weight variables, to detect relevant strategies in the complex association between parental feeding and child’s food intake. Rewarding turned out to be a critical feeding strategy for the child’s unhealthy food intake and obesity risk, whereas modeling seems to have a protective effect. This is important given that previous research mostly considers this behavior as part of restrictive strategies. The separate analysis shows that the rewarding behavior is especially relevant for the child’s eating. In summary, the results point out the existence of modifiable behavior for the development of healthy eating in a child, which could be conveyed to parents during prevention programs and other facilities.

No description available.

This is the final submission of my Masters Thesis. / OBJECTIVES: Cognitive disordered eating behaviours (body shape concerns) are prevalent among youth with higher unhealthy body mass indexes (BMIs), while physical disordered eating behaviours (unhealthy changes in eating habits) are common mechanisms in determining future BMI. This thesis investigates the associations between these disordered eating behaviours and BMI categories and evaluates potential covariate modification. As a secondary objective, this thesis investigates the association between unhealthy eating patterns and BMI categories. METHODS & DATA ANALYSIS: This study was conducted among Canadian youth aged 12-17 (n=12,350). Body shape concerns were measured as the frequency of having a preoccupied desire to be thin while changing eating habits was measured as the frequency of changing eating habits to manage weight. Unhealthy eating patterns were defined as frequent restaurant eating, energy drink consumption, and skipping breakfast. Categorical BMI classifications consisted of obesity, overweight and normal/underweight. Adjusted multinomial logistic regression models were constructed. Covariates were independently tested for statistical interaction in the primary relationships. Measures of association were reported as adjusted odds ratios (ORs) with 95% confidence intervals. RESULTS: Having a preoccupied desire to be thin was associated with increased odds of being overweight and having obesity. These relationships were modified by sex, physical activity, and sleep. Changing eating habits to manage weight was associated with increased odds of being overweight and having obesity. These relationships were modified by sex. Skipping breakfast increased the odds of being overweight and having obesity, while consuming energy drinks increased the odds of having obesity. CONCLUSION: Over 40% of the sample experienced some frequency of having body shape concerns or changing eating habits to manage weight. These disordered eating behaviours increase the odds of being overweight and having obesity. Continued monitoring through national–level surveys, will be crucial in understanding changes in rates of disordered eating behaviour. / Thesis / Master of Public Health (MPH)